• UM LVN Delegation Oversight Nurse

    Molina Healthcare (Long Beach, CA)
    Nurse in good standing. **Preferred Education** Completion of an accredited Registered Nurse (RN) Program or a bachelor's degree in Nursing. **Preferred ... Oversight Nurse ** is responsible for ensuring that Molina Healthcare's UM delegates are compliant all applicable State, CMS, and NCQA requirements, as… more
    Molina Healthcare (03/13/25)
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  • Manager, UM Physical Health Nurse

    Humana (Oklahoma City, OK)
    …in the State of Oklahoma.** + 2+ years of leadership/management experience. + Licensed Registered Nurse (RN) in the State of Oklahoma (or compact license) with ... Horizons in Oklahoma is seeking a Manager, Utilization Management ( UM ) Physical Health Nurse , who utilizes clinical...procedures to provide the best and most appropriate treatment, care , or services for members. The Manager roles and… more
    Humana (03/04/25)
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  • Compliance Nurse - Home Solutions/OneHome…

    Humana (Frankfort, KY)
    …**Required Qualifications** + Less than 5 years of technical experience + Licensed Registered Nurse (RN) in a compact state with no disciplinary action ... our caring community and help us put health first** The Compliance Nurse reviews utilization management activities and documentation to ensure adherence to policies,… more
    Humana (03/13/25)
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  • UM Nurse Consultant

    CVS Health (Austin, TX)
    …skills, both verbal and written **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care /critical care setting - ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
    CVS Health (03/14/25)
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  • UM Reviewer

    Apex Health Solutions (Houston, TX)
    …of Nursing) Licenses/Certifications: Current, unrestricted Texas licensure to practice as a Registered Nurse or Licensed Vocational Nurse required and ... office staff when benefit coverage or UR questions or issues arise. To support care management initiatives, the UM Reviewer should also identify enrollees in… more
    Apex Health Solutions (03/09/25)
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  • Care Manager ( UM /UR) - Remote,…

    Magellan Health Services (Boise, ID)
    …- Licensed Professional Counselor - Care Mgmt, LSW - Licensed Social Worker - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - ... directly influence quality of care . General Job Information Title Care Manager ( UM /UR) - Remote, Idaho Licensed Grade 24 Work Experience - Required Clinical… more
    Magellan Health Services (01/26/25)
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  • UM Clinical Denial Manager

    Sutter Health (Sacramento, CA)
    …* Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** * RN- Registered Nurse of California Upon Hire **TYPICAL EXPERIENCE:** * 8 years ... state regulations and guidelines. Has frequent contact with hospital leadership, Nurse Executives and Directors, Risk Management & Ethics staff, Ancillary Services,… more
    Sutter Health (03/08/25)
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  • UM Clinical Reviewer

    Centers Plan for Healthy Living (Margate, FL)
    …Plan For Healthy Living is currently accepting applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works ... UM Clinical Reviewer 5297 W Copans Rd, Margate, FL...and manage members who are in need of additional care or support in their home to improve their quality… more
    Centers Plan for Healthy Living (03/04/25)
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  • Clinical Letter Writer (Part-time) - RN, LVN/LPN…

    Evolent (Columbus, OH)
    …+ Performs other duties as assigned. **Qualifications: Required and Preferred:** + Licensed registered nurse or LVN/LPN (current and unrestricted) + Minimum of ... + **Minimum one year of experience with Utilization Review ( UM ) in a managed care environment** +...with Utilization Review ( UM ) in a managed care environment** + Cardiology and Oncology Healthcare experience/knowledge +… more
    Evolent (03/11/25)
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  • Registered Nurse : Ambulatory…

    University of Michigan (Ann Arbor, MI)
    REGISTERED NURSE : Ambulatory Care Services (Pediatric Infusion) Apply Now **Mission Statement** The University of Michigan Health System improves the health ... action employer. **Job Detail** **Job Opening ID** 261074 **Working Title** REGISTERED NURSE : Ambulatory Care Services (Pediatric Infusion)… more
    University of Michigan (03/13/25)
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  • Registered Nurse : Ambulatory…

    University of Michigan (Ann Arbor, MI)
    REGISTERED NURSE : Ambulatory Care Services (Ambulatory Care Nurse Resource Pool-Surgical Clinics) Apply Now **Mission Statement** Michigan Medicine ... opportunity/affirmative action employer. **Job Detail** **Job Opening ID** 259480 **Working Title** REGISTERED NURSE : Ambulatory Care Services (Ambulatory … more
    University of Michigan (03/12/25)
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  • Registered Nurse (Ambulatory…

    University of Michigan (Ann Arbor, MI)
    REGISTERED NURSE (Ambulatory Care , East Ann Arbor Operating Room) Apply Now **Mission Statement** Michigan Medicine improves the health of patients, ... opportunity/affirmative action employer. **Job Detail** **Job Opening ID** 261085 **Working Title** REGISTERED NURSE (Ambulatory Care , East Ann Arbor… more
    University of Michigan (03/12/25)
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  • Registered Nurse : Ambulatory…

    University of Michigan (Ann Arbor, MI)
    REGISTERED NURSE : Ambulatory Care Services (Rogel Cancer Center Maize Team - Lymphoma) Apply Now **Mission Statement** The University of Michigan Health ... opportunity/affirmative action employer. **Job Detail** **Job Opening ID** 261114 **Working Title** REGISTERED NURSE : Ambulatory Care Services (Rogel Cancer… more
    University of Michigan (03/13/25)
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  • Registered Nurse - D. Dan and Betty…

    University of Michigan (Ann Arbor, MI)
    …employer. **Job Detail** **Job Opening ID** 260229 **Working Title** REGISTERED NURSE - D. Dan and Betty Kahn Health Care Pavilion: Otolaryngology, Oral ... REGISTERED NURSE - D. Dan and Betty Kahn Health Care Pavilion: Otolaryngology, Oral Surgery, Spine, and Vascular Apply Now **How to Apply** This is a… more
    University of Michigan (03/12/25)
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  • Registered Nurse : Central Staffing…

    University of Michigan (Ann Arbor, MI)
    REGISTERED NURSE : Central Staffing Resources (Pediatric Critical Care Cluster) Apply Now **Job Summary** This is a Central Staffing Resource RN position ... **Job Detail** **Job Opening ID** 257417 **Working Title** REGISTERED NURSE : Central Staffing Resources (Pediatric Critical Care Cluster) **Job Title**… more
    University of Michigan (03/06/25)
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  • Registered Nurse (Ambulatory…

    University of Michigan (Ann Arbor, MI)
    REGISTERED NURSE (Ambulatory Care - Heart Failure Clinic) Apply Now **Mission Statement** Michigan Medicine improves the health of patients, populations and ... opportunity/affirmative action employer. **Job Detail** **Job Opening ID** 260975 **Working Title** REGISTERED NURSE (Ambulatory Care - Heart Failure Clinic)… more
    University of Michigan (03/12/25)
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  • Registered Nurse (Cardiovascular…

    University of Michigan (Ann Arbor, MI)
    REGISTERED NURSE (Cardiovascular Center- CVC 5, Cardiovascular Intensive Care Unit) Apply Now **Mission Statement** Michigan Medicine improves the health of ... **Job Detail** **Job Opening ID** 261001 **Working Title** REGISTERED NURSE (Cardiovascular Center- CVC 5, Cardiovascular Intensive Care Unit) **Job Title**… more
    University of Michigan (03/12/25)
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  • Registered Nurse : University…

    University of Michigan (Ann Arbor, MI)
    REGISTERED NURSE : University Hospital (8D Intermediate Care /Intensive Care Unit) Apply Now **Mission Statement** Michigan Medicine improves the health of ... employer. **Job Detail** **Job Opening ID** 261073 **Working Title** REGISTERED NURSE : University Hospital (8D Intermediate Care /Intensive Care Unit)… more
    University of Michigan (03/12/25)
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  • Registered Nurse : Ambulatory…

    University of Michigan (Ann Arbor, MI)
    REGISTERED NURSE : Ambulatory Care Services (VVWH OB/GYN Clinic) Apply Now **Job Summary** The Department of Obstetrics and Gynecology at the Von Voigtlander ... opportunity/affirmative action employer. **Job Detail** **Job Opening ID** 261065 **Working Title** REGISTERED NURSE : Ambulatory Care Services (VVWH OB/GYN… more
    University of Michigan (03/12/25)
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  • Registered Nurse (Ambulatory…

    University of Michigan (Ann Arbor, MI)
    REGISTERED NURSE (Ambulatory Care , Northville Health Center- Medical Specialty) Apply Now **Job Summary** The Northville Health is an Ambulatory Care ... action employer. **Job Detail** **Job Opening ID** 261007 **Working Title** REGISTERED NURSE (Ambulatory Care , Northville Health Center-… more
    University of Michigan (03/12/25)
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